High-intensity focused ultrasound effectively treats PCA, reduces side effects
New research published in Lancet Oncology details how men with prostate cancer can avoid many of the unpleasant side effects of chemo, surgery and radiation therapy when they are treated with high-intensity focused ultrasound instead.
Experts at Memorial Sloan Kettering Cancer Center (MSK) have been working on this focal therapy for men with intermediate risk (grade group 2 or 3) prostate cancer because they often do not meet eligibility criteria for active surveillance. They explain that these men are at an increased risk of early disease progression and could eventually require radical therapy, which would likely be accompanied by adverse treatment side effects. In trying to develop more suitable alternatives for this cohort of patients, researchers turned to MR-guided high-intensity focused ultrasound (MRgFUS).
“We believe this novel treatment strategy will improve the lives of many prostate cancer patients,” corresponding author Dr. Behfar Ehdaie, who is a urologic surgeon at Memorial Sloan Kettering Cancer Center, and co-authors explained. “To draw a parallel with how breast cancer treatment changed 30 years ago, you could think of focal therapy as a ‘male lumpectomy.’ Instead of removing all the tissue in a breast or prostate, we have learned that it is safe and effective to treat specific areas and greatly reduce the burden on patients.”
MRgFUS is a noninvasive outpatient procedure that can be completed in around two hours. While under anesthesia, men undergo an MRI exam to image the prostate. Doctors use that imaging to map out the treatment area before delivering focused ultrasound waves to the area of interest. Focused ultrasound can attack and kill cancer cells by heating them up to a temperature above 158 °F (70 °C). The treatment comes without incisions or wounds and has thus far been shown to reduce adverse side effects, such as urinary incontinence and impotence, that are common with other forms of prostate cancer treatment.
Researchers at MSK used this method to treat 101 men with grade group 2 or 3 prostate cancer between May 2017 and December 2018. They shared that at 24 months post-treatment 88% of men with grade group 2 cancer did not show any evidence of grade group 2 or higher prostate cancer in the treated area. Additionally, no grade 4 or 5 treatment-related adverse events or deaths were reported.
Based on the results of this phase 2 trial, the FDA in December 2021 granted approval for this treatment on prostate tissue, while also giving the experts a green light to continue to study the clinical benefits of MRgFUS focal therapy in comparison to active surveillance.
“Advancements in prostate cancer over the past two decades have been headlined by successes that have benefited all patients, and now focal therapy provides another exciting area that can move the needle in prostate cancer management,” Dr. Ehdaie said.
View the study abstract here: MRI-guided focused ultrasound focal therapy for patients with intermediate-risk prostate cancer: a phase 2b, multicentre study
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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.